SR0063enr 101ST GENERAL ASSEMBLY

10100SR0063 Enrolled LRB101 08448 ALS 53522 r

SENATE RESOLUTION NO. 63

WHEREAS, An estimated 700 to 900 women now die as a result of pregnancy and childbirth-related causes, and over 60 percent of the pregnancy-related deaths in the United States are preventable; and

WHEREAS, Illinois had more than 150,000 births in 2016 with 72 pregnancy-associated deaths and 985 infant deaths; and

WHEREAS, 72 percent of the pregnancy-related deaths and 93 percent of violent-pregnancy-related deaths were deemed preventable in Illinois by review committees; and

WHEREAS, African American women in the United States experience maternal-related deaths at three to four times the rate of non-Hispanic white women, according to the Mothers and Offspring Mortality and Morbidity Awareness Act, introduced by U.S. Representative Robin Kelly of Illinois in May 2018; and

WHEREAS, Non-Hispanic black women are six times as likely to die of a pregnancy-related condition as non-Hispanic white women in Illinois, according to the Illinois Maternal Morbidity and Mortality Report; and

WHEREAS, The United States has not been able to submit a formal maternal mortality rate to international data repositories since 2007, and, in order to be able to calculate a formal maternal mortality rate, maternal mortality-related data must be streamlined at the State level and extrapolated to the federal level; and

WHEREAS, Leaders in maternal wellness highly recommend that maternal deaths be investigated at the State level first; and

WHEREAS, Among the top common causes of pregnancy-related deaths in Illinois are hemorrhage, infection, and hypertensive disorders of pregnancy; and

WHEREAS, The State of California has established Maternal Mortality Review Committees to determine the most prevalent causes of maternal mortality and recorded and shared data with providers and researchers, who have developed and implemented safety bundles and care protocols related to preeclampsia, maternal hemorrhage, and other prevalent causes of maternal mortality; and

WHEREAS, The Illinois Department of Public Health currently works with the Maternal Mortality Review Committee and the Maternal Mortality Review Committee for Violent Deaths to review cases of maternal death and to develop statewide recommendations to prevent future maternal deaths; and

WHEREAS, In the State of California, state-based maternal quality collaborative organizations have formed obstetrical protocols, tool kits, and other resources to improve system care and response as they relate to maternal complications and warning signs for conditions such as maternal hemorrhage, hypertension, and preeclampsia; and

WHEREAS, Illinois has begun developing protocols and resources to address common causes of maternal mortality in the State, such as implementing new training material regarding hemorrhages through the Obstetric Hemorrhage Education Project (OBHEP) in 2016; and

WHEREAS, The CDC reports that more than half of all maternal deaths occur in the immediate postpartum period, which is between 42 days to a full year after delivery; yet, for pregnant women, Medicaid coverage lapses at the end of the month on which the 60th postpartum day lands; and

WHEREAS, Expanding Medicaid and CHIP coverage for pregnant and postpartum women has been a part of improving federal efforts for the prevention of maternal mortality; and

WHEREAS, Research has shown that, relative to white patients, black patients are less likely to be given pain medications, and, when pain medication is given, they receive lower quantities; and

WHEREAS, A 2015 study from JAMA Pediatrics found that black children with appendicitis were less likely to receive pain medication than their white counterparts; and

WHEREAS, A study examining disparities in the triaging, or giving a degree of urgency to, pediatric emergency department patients concluded that black, Hispanic, and Native American patients received lower acuity triage scores than whites when presenting subjective complaints, such as breathing difficulty or abdominal pain; and

WHEREAS, Researchers have also documented an association between race and increased mortality from stroke, and others have found that minority patients are less likely to receive thrombolytics than white patients; and

WHEREAS, A study in the Proceedings of the National Academy of Sciences contributes bias in pain assessment and management of patients partially to the fact that about half of medical students and residents believed inaccurate biological differences between black and white people, including that black people have less sensitive nerve endings or that a black person's blood coagulates more quickly, as well as other unconscious biases; and

WHEREAS, Biases in patient assessment and treatment affect the level of care for pregnant women, particularly women of color; and

WHEREAS, The provider pool is not primed with many people of color, nor are providers consistently required to undergo implicit bias, cultural competency, or empathy training on a consistent, on-going basis; and

WHEREAS, Studies have also shown that women are generally less likely to be diagnosed with diseases, such as heart disease, and are less likely to receive aggressive treatment for pain management and certain diseases than men; and

WHEREAS, There have been efforts to address implicit bias and cultural competency at the federal level by awarding cooperative agreements for the establishment or support of regional centers of excellence addressing implicit bias and cultural competency in patient-provider interactions for the purpose of enhancing and improving how health care professionals are educated in implicit bias and delivering culturally competent health care; therefore, be it

RESOLVED BY THE SENATE OF THE ONE HUNDRED FIRST GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that the State of Illinois recognizes the importance of investigating and addressing maternal mortality issues in the State; and be it further

RESOLVED, That we urge the General Assembly to investigate and identify areas in which the State can improve with respect to the prevention of maternal mortality, especially among vulnerable populations.